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Ask Dr. Sears: Mongolian Spots

QYesterday friends were over with their two-month-old daughter. I was playing with her and put her on her tummy, when I noticed a huge bruise totally covering her butt and her back. It was the scariest sight I have ever seen. Later, her dad asked if I had seen her Chinese birthmark. I have never heard of such a thing. Do they really exist or should I prepare to take action for this helpless little one?

A.The bruise-like marks you noticed on your friend's baby are a common birthmark called "Mongolian Spots." This term stems from the fact that descendants from the original Mongolian empire—Asians, Hispanics, African Americans and even Native Americans—inherit this quirk. These spots, occur in around 90 percent of Asians, Hispanics and African Americans, and sometimes even in Caucasians.

They're most common on the lower back, buttocks and the back of the thighs. They are usually present at birth or shortly after, but most fade partly or completely by the time the child enters school. Occasionally, the spots will persist in varying degrees throughout adulthood. These common birthmarks are caused by a large concentration of melanocytes (cells that contain dark pigment) that collect beneath the skin. The extra cluster of cells poses no risk of skin cancer or any other disease. They are harmless and require no treatment, but may pose a social concern—as you have realized.

If Your Child Has Mongolian Spots...

Because these spots are not always understood, they may get parents in trouble. I have been a consultant in cases in which these birthmarks were mistaken for "spank marks." To avoid this embarrassment, it's important to take pictures of these spots early in infancy and file them away.

When your child is old enough to understand, possibly around three years of age, play show-and-tell. Tell her she was born with these "special spots" and show her pictures of them. So she doesn't feel "different," reassure her that many kids have these special spots and they usually fade with time. If they don't, they're just, well, "special."

When starting your child with a new daycare provider, be sure to mention her Mongolian spots. Yet, try to explain these spots privately so your child does not become self-conscious about them. (Remember to call them her "special spots.") These spots are especially common in children who are adopted from foreign countries, so it's particularly important for adopting parents to explain these spots to other people. While most social workers are familiar with these normal birthmarks, don't take that chance. Record them by photo and always explain them.